Provider Demographics
NPI:1841558756
Name:MEREDITH O'BRIEN, LCSW, LLC
Entity Type:Organization
Organization Name:MEREDITH O'BRIEN, LCSW, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:MEREDITH
Authorized Official - Middle Name:EILEEN
Authorized Official - Last Name:O'BRIEN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:914-260-3207
Mailing Address - Street 1:43 TOWER HILL AVE
Mailing Address - Street 2:
Mailing Address - City:RED BANK
Mailing Address - State:NJ
Mailing Address - Zip Code:07701-2224
Mailing Address - Country:US
Mailing Address - Phone:914-260-3207
Mailing Address - Fax:
Practice Address - Street 1:47 RECKLESS PL
Practice Address - Street 2:
Practice Address - City:RED BANK
Practice Address - State:NJ
Practice Address - Zip Code:07701-1750
Practice Address - Country:US
Practice Address - Phone:914-260-3207
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-27
Last Update Date:2012-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC053843001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty